Real-World Effectiveness of Nivolumab Monotherapy After Prior Systemic Therapy in Advanced Non–Small-Cell Lung Cancer in the United States

David D. Stenehjem, Solomon J. Lubinga, Komal Gupte-Singh, Ying Zhang, Trong Kim Le, John R. Penrod, Cardinale B. Smith

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

BACKGROUND: In phase 3 clinical trials, nivolumab prolonged overall survival (OS) compared to chemotherapy in patients with previously treated advanced non-small-cell lung cancer (NSCLC). This retrospective real-world study evaluated OS in patients receiving nivolumab for previously treated advanced NSCLC primarily in US community hospitals.

PATIENTS AND METHODS: Patient data were taken from electronic health records in the Flatiron Health oncology database. OS was evaluated in patients receiving nivolumab monotherapy for nonsquamous or squamous advanced NSCLC after prior chemotherapy; subgroup analyses were performed by Eastern Cooperative Oncology Group performance status (ECOG PS), age, and other baseline characteristics. Cox analysis was used to determine OS predictors.

RESULTS: Of 3019 included patients, 1968 (65%) had nonsquamous and 1051 (35%) had squamous histology. In both cohorts, approximately 20% of patients had a verified ECOG PS ≥ 2, and > 25% were aged ≥ 75 years. For all patients, median OS in the nonsquamous and squamous cohorts was 8.6 months (95% confidence interval [CI], 8.0-9.3) and 7.4 months (95% CI, 6.8-8.5), respectively; for those with ECOG PS 0-1, median OS was 10.8 months (95% CI, 9.8-11.8) and 8.7 months (95% CI, 7.6-9.7), respectively. In both cohorts, programmed death ligand 1 expression ≥ 1% and ECOG PS 0-1 were associated with longer OS (P < .05); the number of prior lines of therapy and age ≥ 75 years had no significant association with OS.

CONCLUSIONS: This study confirmed the effectiveness of nivolumab monotherapy for previously treated advanced NSCLC in real-world clinical practice. Poor ECOG PS, but not advanced age, was associated with shorter OS.

Original languageEnglish (US)
Pages (from-to)e35-e47
JournalClinical Lung Cancer
Volume22
Issue number1
DOIs
StatePublished - Jan 2021

Bibliographical note

Funding Information:
This study was supported by Bristol Myers Squibb. D.D.S. reports research funding to his institution from Bristol Myers Squibb, Novartis, AstraZeneca, and Bioverativ, and personal consulting fees from Salarius Pharmaceuticals, Iterion Therapeutics, Dracen Pharmaceuticals, Molecular Templates, and Bristol Myers Squibb. S.J.L., K.G.-S., Y.Z., T.K.L., and J.R.P. are employees and stockholders of Bristol Myers Squibb. C.B.S. reports speaker fees from Teva Pharmaceuticals.Medical writing assistance was provided by Roland Tacke, PhD, Evidence Scientific Solutions, funded by Bristol Myers Squibb.

Funding Information:
This study was supported by Bristol Myers Squibb . D.D.S. reports research funding to his institution from Bristol Myers Squibb , Novartis, AstraZeneca, and Bioverativ , and personal consulting fees from Salarius Pharmaceuticals, Iterion Therapeutics, Dracen Pharmaceuticals, Molecular Templates, and Bristol Myers Squibb. S.J.L., K.G.-S., Y.Z., T.K.L., and J.R.P. are employees and stockholders of Bristol Myers Squibb. C.B.S. reports speaker fees from Teva Pharmaceuticals.

Publisher Copyright:
© 2020 The Authors

Keywords

  • Advanced age
  • Observational study
  • Overall survival
  • Performance status
  • Progression-free survival

PubMed: MeSH publication types

  • Journal Article
  • Observational Study
  • Research Support, Non-U.S. Gov't

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